CAPE CORAL

LEHIGH ACRES

BONITA SPRINGS

Macular Degeneration

What is Macular Degeneration?

Macular degeneration is also known as age-related macular degeneration (ARMD), AMD, and an old term senile macular degeneration or SMD. Macular degeneration is characterized by degeneration of the cells in the retina located in the macula. The macula is located in the center of the retina and is responsible for our clear vision. The retina is like the film of a camera. The retina receives the image and turns it into an electrochemical charge. This data is transferred from the retina and through the optic nerve from the back of the eye to the vision center in the occipital lobe in the back portion of the brain. The macula is the specialized portion of the retina that provides our central clear vision. It is composed of millions of light- sensing cells. The macula is responsible for our ability to read, drive a car, watch TV, look at a computer, or anything that requires good vision. You are unable to read or see clearly with your side vision. Macular degeneration is the leading cause of permanent blindness in the United States in people over age 65. In the initial stages of the disease there may be no symptoms. In most cases the macular degeneration advances at a slow rate. In a smaller percentage of people, it may advance rapidly.

Risk Factors for Age-Related Macular Degeneration

Age – ARMD is an aging process of the cells in the macula. The incidence of ARMD increases with age. For people in their sixties, the incidence is about 12 to 13 percent. For people over age 80, the incidence is approximately 1/3 of people have RAMD.

Race – ARMD is more common in Caucasians verses African-Americans or Latinos.

Genetics – At this time more than 20 genes have been found related to ARMD.

General Health – Regular exercise has been shown to reduce the incidence of ARMD. Obesity may double the risk of ARMD. High blood pressure may also increase the risk of ARMD. Diet may also play a role in the development of ARMD.

High Cholesterol – This may lead to a higher risk.

High Fat Intake – High intake of saturated fats, trans fats, and omega-6 fatty acids from animal sources may increase the risk.

UV Light – There is research that shows exposure to significant sunlight may increase the risk of ARMD.

Oxidative Stress – The release of free radicals may increased the risk of macular degeneration.

What are the Symptoms of Macular Degeneration?

Macular degeneration is usually a slow, insidious, and painless loss of vision. In a smaller number of cases, there may be a sudden loss of vision. People begin to notice ghosting of images, blurring, and distortion (metamorphopsia) of images. You may notice that telephone or light poles are crooked or have a bend in them. You may experience a slow recovery of vision after exposure to bright light such as coming indoors from the outside or going to an afternoon movie and not seeing for a period of time in the movie theater. You also may have trouble with colors such as one dark color from another. As the disease progresses, there can be a total loss of the central vision. In almost all cases, the side vision remains intact.

How is Macular Degeneration Diagnosed?

In the beginning of macular degeneration, there are usually no symptoms. Your eye may find that you have ARMD before you are aware of any vision difficulty.

Comprehensive Dilated Eye Examination

You are asked to read a chart on the wall and the size of letters are recorded. It is important for the eye doctor to know your best correctable vision. A refraction may be performed to determine your best correctable vision. If you are not 20/20, then the cause for the decreased vision needs to be identified such as macular degeneration.

OCT is a non-invasive test that uses light waves to scan and image the retina. The OCT is able to image the different layers of the retina in high resolution. It will show any abnormalities in any of the layers of the retina. After your eyes are dilated you will be placed in front of the instrument and asked to fixate on a target. The instrument will scan your retina in painless manner.

After your eyes are dilated, fluorescein dye is injected into a vein in your arm. Pictures are taken of the retina in rapid sequence as the dye courses through the arteries, veins, and capillaries in the retina, especially the macula. The angiogram will show any abnormalities in the blood vessels, leaking vessels, blockages in the vessels, and/or microaneurysms. This test will help the eye doctor diagnose the type of macular degeneration.

This is similar to a fluorescein dye test as a different type of dye is injected into the blood stream.

After completion of the tests and the eye doctor examines your eyes, they will inform you of their finding. The eye doctor is looking for any abnormalities in the macula. They will look for the presence of drusen which are yellow colored deposits under the retina. These are sign of possible macular degeneration or that you are at risk of developing macular degeneration. They are also looking for changes in the pigment layer of the retina. The pigment is the same pigment as found in the iris or colored portion of the eye. The pigment layer will show degeneration or clumping or loss of pigment in macular degeneration.

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(One of Dr. Croley’s patients wrote the following letter to local news organizations)

Good Afternoon: Thought I’d give you a heads-up for a true community service feature.

James Croley, MD is an eye surgeon located in Cape Coral [Bonita Springs and Lehigh Acres]. He has been serving in Cape Coral for about 30 years and has grown to be world renowned.

Dr. Croley enjoys a reputation, as a result of his professionalism and accomplishments, that serve to set him apart from any other in a delicate field. He’s a giving, feeling individual, dedicated to making better those things that serve to improve the quality of life in our society.

Dr. Croley has now authored a fabulous book entitled “Believing is Seeing.” The book is designed to provide insights into how to improve one’s health and welfare in a complicated world….and does just that!

I believe that a feature focusing on the life and times of this extraordinary man would represent a true community service. In line with the Doctor’s giving persona…proceeds from the book sales will be donated towards Missions.

Happy Easter & God Bless,

Dick

Dr. Croley, Thank you for seeing me as a new patient! You came highly recommended by [a friend] and I found my experience to be not only professional and thorough, but friendly as well! See you in February for a six-month check.

My Best, Kerry

Ps. It was a pleasure meeting your staff as well!”

Kerry

Very professional office, staff and doctor.

Ron

I did not always know why I was doing some procedures but the end result was great and much better than expected.

Zadok

I trust Dr.Croley with my eyes. He is the best eye doctor I have ever been to. He is genuinely concerned about my pressures and being diabetic he keeps track of any changes. I would and have recommended him to my friends. I feel blessed that Dr. Croley is looking after me.

Karen

Trust completely. Do not want to ever have to change doctor.

Barbara

Very pleased and love the entire staff. Will highly recommend Dr. Croley. I have good results.

Beverly

I’m now excited to get the other eye done.

Judith

Dr.Croley and his friendly, efficient staff make my appointments very pleasant. I also appreciate Dr. Croley’s current knowledge of new procedures and possibilities.

Judy

Very nice office, great staff very caring & friendly

Angela

Has many patients but devotes time only for you when with you. Made me feel very much at ease with her compassion and personal interest. Office staff very courteous & definitely trust Dr. Croley.

Mareann

Dr.Croley is well-versed and articulate and maintains state-of-the-art knowledge and technology. No reservations in recommendations.